Cerebral microbleeds: a new dilemma in stroke medicine.

Abstract

Cerebral microbleeds (CMBs) are an increasingly common neuroimaging finding in the context of ageing, cerebrovascular disease and dementia, with potentially important clinical relevance. Perhaps the most pressing clinical question is whether CMBs are associated with a clinically important increase in the risk of intracerebral haemorrhage (ICH), the most feared complication in patients treated with thrombolytic or antithrombotic (antiplatelet and anticoagulant) drugs. This review will summarize the evidence available regarding CMBs as an indicator of future ICH risk in stroke medicine clinical practice.

(a) Susceptibility-weighted imaging (SWI) is currently the most sensitive means for the detection of cerebral microbleeds (CMBs). Although SWI can detect significantly more CMBs compared with conventional T2*-weighted gradient-recalled echo (T2*-GRE) magnetic resonance imaging, whether it has ‘added value’ in clinical practice is still under investigation